Despite higher levels of morbidity and mortality, African American children receive asthma care that is less consistent with national asthma guideline recommendations compared to white children. Access to care, insurance status and socioeconomic status have not fully explained these disparities. Poor assessments of asthma morbidity and suboptimal communication between physicians and parents of inner-city children with asthma may contribute racial disparities in quality of asthma care. We propose to examine the effects of an asthma-focused communication intervention on parent-physician communication and quality of asthma care among inner-city African American children. The objective of this project is to design, validate and implement an effective Pediatric Asthma Control and Communication Instrument (P-ACCI) within an innercity- based, university pediatric clinic. We therefore propose the following Specific Aims: 1) To develop and validate a simple, paper-and-pencil pediatric asthma control and communication instrument (P-ACCI) to serve as a both a prompt and a communication aide for the physician and the parent to discuss issues of asthma health; 2) To conduct a pilot randomized clinical trial in a primary care pediatric setting of inner-city African American children with asthma in order to assess the effects of the P-ACCI on the quality of patientphysician communication and quality of asthma care. We hypothesize that: 1) the P-ACCI is a valid measure of asthma morbidity; 2) regular use of the P-ACCI will improve the quality of parent-physician communication and the quality of asthma care for children. Relevance: There is a pressing need for simple, low-cost clinical strategies applicable in diverse settings to improve communication about variables important to asthma management. Such strategies would enhance clinical judgment, decision-making, and quality of asthma care. The current study will evaluate a novel, lowcost tool with the potential to reduce asthma care disparities related to poor parent-physician communication My career goals involve becoming a successful investigator of racial disparities in quality of asthma care, and to become a Professor of Pediatrics who develops remedies to improve asthma care through a multidisciplinary research center, and to reduce racial disparities in asthma care and asthma outcomes. (End of Abstract)